Crain's New York Business Reports on Sen. Johnson's Medicaid Hearing

Craig M. Johnson

Providers blast Medicaid Inspector General audits

As expected, Sen. Craig Johnson, D-Nassau, got an earful yesterday at the New York Senate Investigations Committee's hearing on the efforts of the Office of the Medicaid Inspector General to crack down on Medicaid fraud. The scheduled witnesses—representatives of the New York Association of Homes and Services for the Aging, the New York State Health Facilities Association, HANYS, GNYHA and the Home Care Association of New York State—painted a portrait of harassed providers completely overwhelmed by OMIG's unrelenting investigations.

The trade group representatives testified that they couldn't get personnel from hospitals, nursing homes or home care agencies to come to the hearing because they were intimidated and afraid of repercussions. The reps spoke of auditors who were inexperienced and uneducated. They mentioned facilities that passed Department of Health audits, only to be cited by OMIG on the same issues that had been audited. They remarked upon a lack of communication among OMIG divisions.

But above all, they described a blazing pace of OMIG investigations, which they trace to pressure on the office to recover hundreds of millions of dollars lost to Medicaid fraud under the state's FSHRP waiver. Since August 2008, OMIG posted 1,300 financial audits, GNYHA testified. In comparison, the federal OMIG posted a mere 205.

“This intensity can't go on without significant implications for providers and their finances,” said GNYHA.